Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Mancuso

Individual provider Physical Therapist · NPI 1134912728

Jack Mancuso is a Physical Therapist in Private Practice in Chicago, Illinois. Qualified in 2025, 1 year ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
1
Licensed in
IL
In the registry since
2025

Practice location Address checks out

1323 W Diversey Pkwy
Chicago, IL 60614-1207
Phone: (773) 549-2520
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070-029130 (IL)

Record details

NPI number1134912728
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 27, 2025
Last updated in NPPESMay 27, 2025
Certification dateMay 27, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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